Short-Stay Left Colectomy for Colon Cancer: Is It Safe?

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Health Services Research

Background:

• Surgical advancements have reduced hospital length of stay (LOS) post-surgery.
• The safety of short-stay (≤24-hour) left colectomy for colon cancer patients in the US remains under investigation.

Purpose of the Study:

• To determine the safety and feasibility of short-stay left colectomy for colon cancer patients.
• To compare outcomes of short-stay colectomy with longer hospital stays.

Main Methods:

• Analysis of adult colon cancer patients undergoing elective left colectomy from the American College of Surgeons NSQIP database (2012-2021).
• Patients categorized into four LOS groups: ≤24-hour, 2-4 days, 5-6 days, and ≥7 days.
• Primary outcomes: 30-day postoperative overall and serious morbidity. Secondary outcomes: 30-day mortality and readmission. Multivariable logistic regression used.

Main Results:

• A total of 15,745 patients were analyzed; 1.87% (294) had a short stay (≤24-hour).
• Short-stay patients were younger and healthier, with significantly lower 30-day overall morbidity (3.74% vs. 7.38% to 37.64%, p < 0.001).
• Adjusted analysis showed no significant difference in overall or serious morbidity between short-stay and 2-4 day LOS groups. Mortality and readmission rates were also comparable.

Conclusions:

• Short-stay left colectomy is a safe option for carefully selected colon cancer patients in the US.
• Current utilization rates are low, suggesting a need for improved patient selection and clinical pathway optimization.
• Further research and refined protocols could increase the feasibility of short-stay colectomies.